- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,040.67 / $2,683.00 / $9,149.89
| Facility | | $1,040.67 | $2,683.00 | $9,149.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,367.00 / $5,467.00 / $9,283.00
| Facility | | $2,367.00 | $5,467.00 | $9,283.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.00 / $30.00 / $30.00
| Facility | | $30.00 | $30.00 | $30.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,834.00 / $19,913.50 / $26,542.00
| Facility | | $3,834.00 | $19,913.50 | $26,542.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,905.00 / $6,073.00 / $10,287.00
| Facility | | $2,905.00 | $6,073.00 | $10,287.00 |